Provider Demographics
NPI:1891478574
Name:JOHNSON, ROSHAWNDA ELERIA (ACSW, MSW)
Entity Type:Individual
Prefix:
First Name:ROSHAWNDA
Middle Name:ELERIA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ACSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21711 S FIGUEROA ST
Mailing Address - Street 2:APT 417
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745
Mailing Address - Country:US
Mailing Address - Phone:248-872-7829
Mailing Address - Fax:
Practice Address - Street 1:900 QUEBEC AVE
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-9715
Practice Address - Country:US
Practice Address - Phone:559-992-7111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program